Episode Details

The typical primary care physician is incompetent in every measurable respect. This is a huge problem.

Here, I make the case that

• Primary care physicians are broadly, grossly incompetent
• This is due to empty credentialism
• Making it much (~10X) easier to become a PCP is a good solution

Primary Care Physicians are Broadly, Grossly Incompetent

The standard of competence I am comparing primary care physicians against is:

• They should be able to reliably diagnose diseases they are trained to diagnose.
• They should be knowledgeable to a standard similar to what is required to qualify as a doctor
• They should be attentive and empathetic towards patients
• Visiting them is empirically superior to not visiting them

When actually examined according to these standards, PCPs fail on all counts.

Failure to diagnose uncommon diseases is rampant

A survey of patients with rare diseases found that, in about half of cases, patients received at least one incorrect diagnosis, and two thirds required visits to at least three different doctors before being diagnosed. For 30% of them, a correct diagnosis took over five years.

Another survey of children with rare diseases showed that 38% of them needed to see six or more [...]

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Outline:

(00:32) Primary Care Physicians are Broadly, Grossly Incompetent

(07:31) Empty, Unmeritocratic Credentialism is A Major Cause For The Inadequacy Of Primary Care Physicians

(14:49) Making it much easier to become a PCP is a solution

The original text contained 1 footnote which was omitted from this narration.

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First published:
May 2nd, 2026

Source:
https://www.lesswrong.com/posts/QYyBAXqGgNADJDhcP/primary-care-physicians-are-incompetent-we-need-more-of-them

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Narrated by TYPE III AUDIO.